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食管胃十二指肠镜检查对慢性腹痛儿童的诊断价值

Diagnostic yield of esophagogastroduodenoscopy in children with chronic abdominal pain.

作者信息

Akbulut Ulas Emre, Emeksiz Hamdi Cihan, Kocak Fatma Gulgun, Livaoglu Ayten

机构信息

Department of Pediatric Gastroenterology, Hepatology and Nutrition, Kanuni Training and Research Hospital, Trabzon, Turkey.

Department of Pediatric Endocrinology and Diabetes, Kanuni Training and Research Hospital, Trabzon, Turkey.

出版信息

Arch Med Sci. 2018 Jan;14(1):74-80. doi: 10.5114/aoms.2017.67675. Epub 2017 Jul 31.

Abstract

INTRODUCTION

Chronic abdominal pain (CAP) is one of the most common indications of esophagogastroduodenoscopy (EGD) in the pediatric population. However, there is not enough information about the diagnostic yield of EGD in children with CAP. We aimed to evaluate the diagnostic yield of EGD in children with CAP in the Eastern Black Sea region of Turkey.

MATERIAL AND METHODS

The study included children ( = 372) who underwent EGD for the primary indication of chronic abdominal pain during an 18-month period. We collected data on demographic features (age, sex), clinical characteristics (alarm symptoms), and EGD results for each patient.

RESULTS

Patients' mean age was 13 years (range: 4-17 years; mean ± SD: 12.65 ±3.39 years), and the majority were female ( = 234, 62.9%). Endoscopy was diagnostic in 209 patients (56.2%; 95% CI: 30.35-40.05%). The most common diagnosis was gastritis (35.2%) followed by reflux esophagitis. Significantly greater diagnostic yield of EGD was determined in patients with alarm symptoms (65.1%) compared to those without (45.2%) (OR = 2.26, 95% CI: 1.49-3.44, = 0.001).

CONCLUSIONS

We determined a high diagnostic yield of EGD in children with CAP. Although the diagnostic yield of EGD in the assessment of CAP was found to be higher in the presence of alarm symptoms, a significant number of children without alarm symptoms were also found to have gastrointestinal system pathology diagnosed by EGD.

摘要

引言

慢性腹痛(CAP)是儿科人群中食管胃十二指肠镜检查(EGD)最常见的指征之一。然而,关于EGD在CAP患儿中的诊断率,目前尚无足够信息。我们旨在评估土耳其黑海东部地区CAP患儿EGD的诊断率。

材料与方法

本研究纳入了在18个月期间因慢性腹痛这一主要指征接受EGD检查的儿童(n = 372)。我们收集了每位患者的人口统计学特征(年龄、性别)、临床特征(警示症状)及EGD检查结果。

结果

患者的平均年龄为13岁(范围:4 - 17岁;均值±标准差:12.65±3.39岁),大多数为女性(n = 234,62.9%)。209例患者的内镜检查具有诊断意义(56.2%;95%置信区间:30.35 - 40.05%)。最常见的诊断是胃炎(35.2%),其次是反流性食管炎。与无警示症状的患者(45.2%)相比,有警示症状的患者EGD诊断率显著更高(65.1%)(比值比 = 2.26,95%置信区间:1.49 - 3.44,P = 0.001)。

结论

我们确定EGD在CAP患儿中具有较高的诊断率。尽管在有警示症状的情况下,EGD在评估CAP时的诊断率较高,但也发现相当数量无警示症状的儿童经EGD诊断患有胃肠系统疾病。

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